This is a repository copy of Preservation vs. resection of the infrapatellar fat pad during total knee arthroplasty Part I: A survey of current practice in the UK.

Cite this article: Bone Joint Open 2020;1-11:706–708.

Introduction and Aim: Modern knee replacements aim to improve patient function in arthritis affecting different compartments of the knee. This study evaluates the Patient Reported Outcome Measure (PROM) and functional outcome of a modern total knee replacement (Attune, DePuy) in patients with isolated patellofemoral arthritis. Methods: A total of 50 consecutive patients with isolated unilateral patellofemoral arthritis having had Attune total knee replacements at a single institution between 2010 and 2016 were prospectively studied. Five patients who developed symptoms on the opposite side during the study and two patients lost to follow-up were excluded. One patient needed early revision for loosening, leaving a total of 42 patients to be followed up over a period of 4 years. The Oxford Knee score (OKS) and Knee Injury and Osteoarthritis Outcome Score (KOOS) recorded pre-operatively and at follow-up was compared. A Functional assessment at around 8 months after operation was undertaken. Results: At average follow-up of 24 months the mean OKS score improved by 15 points and the KOOS score improved by 20 points. Final KOOS sub-score for Pain was 80, Symptom 80, and ADL 82, Sports & Recreation 32 and QOL 60. Functional assessment at mean 8 months showed that a significant number of patients were able to Kneel (50%); Sit cross legged (23%); sit on their heel (23%) and were able do a single leg dip test (86%). Conclusion: This unique study of a modern design total knee replacement (Attune) in patients with isolated unilateral patellofemoral arthritis shows good PROM scores at 2 years and good functional assessment results at 8 months. The PROM scores are marginally better than the published results with Attune’s predecessor, in a similar cohort of patients, but falls short of the published results of patellofemoral replacement implants. Large randomised comparative studies between traditional and the modern implant design is recommended to answer the question if design modification has influenced clinical outcome in patients with patellofemoral arthritis.

Objective: To find out the effect of Maitland Mobilization Technique versus Muscle Energy Technique on pain, range of motion and functional activities among subjects with Adhesive Capsulitis. Method and Subjects: 28 subjects with aged 40-65 years were selected for this study. They were randomly divided in to two groups. Group A-14 Subjects were received Maitland Mobilization Technique, Group B-14 Subjects were received Muscle Energy Technique for a period of 2 weeks. The pre and post score values of pain were measured by NPRS, for all shoulder ROM by goniometer and functional activities by SPADI. Data were analyzed by SPSS-20 to determine the effects of both the treatment regimens on the same outcome measures. Results: The patients with adhesive capsulitis who treated with Maitland Mobilization Technique and Muscle Energy Technique both showed significant improvement (p<0.001) on pain, shoulder range of motion and the Shoulder Pain And Disability Index scores in adhesive capsulitis. On analyzing the data between groups, there was a clinical improvement but statistical insignificant was noticed (p>0.05) for all parameters. Conclusion: The study confirmed that both Maitland Mobilization Technique and Muscle Energy Technique had better effect on pain, range of motion and improving functional activities. But comparing both groups was insignificantly changes for all parameters.